Delirium diagnostic tool-provisional (DDT-Pro) scores in delirium, subsyndromal delirium and no delirium

Vásquez, José Gabriel Franco; Trzepacz, Paula T.; Sepúlveda, Esteban; Ocampo, María Victoria; Velásquez-Tirado, Juan David; Zaraza, Daniel R.; Restrepo, Cristóbal; Giraldo, Alan; Serna, Paola A.; Zuluaga, Adolfo; López, Catalina Álvarez

doi:10.1016/j.genhosppsych.2020.10.003

Cited by 12 publications

(11 citation statements)

References 38 publications

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“…Item 3 rating values were reversed to align with the scoring for the CTD items. These items represent symptoms from each of the three core domains that are characteristic of delirium (cognitive, higher-level thinking, and circadian) (22,23,30). Total DDT-Pro scores range from 9 points (best) to 0 (worst), where each item is scored 0-3.…”

Section: Instrumentsmentioning

confidence: 99%

Etiologies of Delirium in Consecutive COVID-19 Inpatients and the Relationship Between Severity of Delirium and COVID-19 in a Prospective Study With Follow-Up

Velásquez-Tirado

Trzepacz

Vásquez

2021

JNP

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The investigators aimed to describe delirium etiologies and clinical characteristics, as well as the relationship between COVID-19 and delirium severities, at baseline and follow-up after delirium improvement among patients with SARS-CoV-2 infection.Methods: A longitudinal study of 20 consecutive critically ill, delirious COVID-19 inpatients, assessed with the Charlson Comorbidity Index-Short Form (CCI-SF), COVID-19 Clinical Severity Scale (CCSS), Delirium Etiology Checklist, Delirium Motor Subtype Scale-4, and Delirium Diagnostic Tool-Provisional (DDT-Pro), was conducted. Correlational analysis of delirium severity (DDT-Pro) with each measure of clinical severity (CCI-SF and CCSS) and comparison of baseline DDT-Pro scores between patients who were living and those who were deceased at follow-up were conducted.Results: Participants were 50-90 years old (male, 75%; hypertension, 60%). The prevalence of preexisting medical comorbidities (CCI-SF) was low and not correlated with delirium severity (p50.193). Eighteen patients were on mechanical or high-flow noninvasive ventilation at baseline in the intensive care unit (ICU; CCSS scores 2-4). Delirium severity (DDT-Pro scores 0-6) correlated with COVID-19 severity (0.459, p50.021). Delirium motor subtype was hyperactive in 75% of patients. There were three to four etiologies for delirium in each patient, most commonly organ insufficiency (100%), systemic infection (100%), and metabolic and endocrine disturbances (95%). The baseline DDT-Pro score was #4 for five (25%) patients who died before the final assessment, with a trend of being lower than that for survivors (x 2 53.398, p50.065).Conclusions: Among inpatients with COVID-19, at least three different etiological categories were identified for delirium. ICU staff treating patients with severe cases of COVID-19 should anticipate a greater severity of delirium. Although multivariate analyses with larger study samples are needed, more severe delirium may herald greater risk of death among COVID-19 patients.

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Section: Instrumentsmentioning

confidence: 99%

Etiologies of Delirium in Consecutive COVID-19 Inpatients and the Relationship Between Severity of Delirium and COVID-19 in a Prospective Study With Follow-Up

Velásquez-Tirado

Trzepacz

Vásquez

2021

JNP

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“…To ensure that the tool would be clinically useful, the opti-mal cutoff for delirium diagnosis was obtained via ROC analyses; this was ≤6 or ≤7, as for the English and Spanish versions. 16,18,19 Considering subsyndromal delirium (SSD), the scores of 6 and 7 indicate SSD and full delirium is denoted by the lower score range. 19 Compared to the original validation studies of DDT-Pro (sensitivity 100% and specificity 94% in Kean et al, 18 2010; sensitivity 90% and specificity 87% in Franco et al, 16 2020), the K-DDT-Pro exhibited similar sensitivity and specificity values.…”

Section: Discussionmentioning

confidence: 99%

“…16,18,19 Considering subsyndromal delirium (SSD), the scores of 6 and 7 indicate SSD and full delirium is denoted by the lower score range. 19 Compared to the original validation studies of DDT-Pro (sensitivity 100% and specificity 94% in Kean et al, 18 2010; sensitivity 90% and specificity 87% in Franco et al, 16 2020), the K-DDT-Pro exhibited similar sensitivity and specificity values. Our work had several limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Although the English and Spanish versions of DDT-Pro have been validated with excellent results, validation in other languages employed by specific patient populations is also required. 16,19,20 A Korean version would be useful as Korean hospitals lack such tools. We translated the DDT-Pro from English to Korean (Korean version of the DDT-Pro, K-DDT-Pro).…”

Section: Introductionmentioning

confidence: 99%

“…The previous validation study of the DDT-Pro in general hospital patients shows a significant advance over the commonly used CAM. Although the English and Spanish versions of DDT-Pro have been validated with excellent results, validation in other languages employed by specific patient populations is also required [ 16 , 19 , 20 ]. A Korean version would be useful as Korean hospitals lack such tools.…”

Section: Introductionmentioning

confidence: 99%

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Validation of the Korean Version of the Delirium Diagnostic Tool-Provisional (K-DDT-Pro)

Kim

Shim

et al. 2022

Psychiatry Investig

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Objective The Delirium Diagnostic Tool-Provisional (DDT-Pro) was designed to detect the presence and severity of delirium briefly and objectively regardless of psychiatric expertise. We translated the DDT-Pro into Korean and validated it in elderly Korean patients.Methods To validate the translation and evaluate inter-rater reliability, a psychiatric trainee and a research nurse independently assessed the same patients referred to the Department of Psychiatry. The results were compared with the reference evaluations performed by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).Results We enrolled 42 elderly patients. The Cronbach’s alpha coefficient were 0.839 (the trainee), 0.822 (the nurse). The Cohen’s weighted κ between the trainee and nurse, ranged from 0.555±0.102 to 0.776±0.062. The Pearson correlation coefficients (Korean version of the DDT-Pro [K-DDT-Pro] and Korean version of the Delirium Rating Scale-Revised-98 [DRS-R98-K] total score) were γ=-0.850 (the trainee), and γ=-0.821 (the nurse). The areas under the ROC curves (AUCs) were 0.974 (the trainee) and 0.893 (the nurse).Conclusion The K-DDT-Pro exhibited high internal consistency and relatively substantial inter-rater reliability. The correlation with the DRS-R98-K was strongly negative. The accuracy of the K-DDT-Pro was excellent, regardless of expertise. In conclusion, the K-DDT-Pro is a brief and simple tool that usefully screens for delirium in elderly patients.

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Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) in a skilled nursing facility and comparison to the 4 ‘A’s test (4AT)

Sepúlveda

Bermúdez

González

et al. 2021

General Hospital Psychiatry

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Delirium diagnostic tool-provisional (DDT-Pro) scores in delirium, subsyndromal delirium and no delirium

Cited by 12 publications

References 38 publications

Etiologies of Delirium in Consecutive COVID-19 Inpatients and the Relationship Between Severity of Delirium and COVID-19 in a Prospective Study With Follow-Up

Etiologies of Delirium in Consecutive COVID-19 Inpatients and the Relationship Between Severity of Delirium and COVID-19 in a Prospective Study With Follow-Up

Validation of the Korean Version of the Delirium Diagnostic Tool-Provisional (K-DDT-Pro)

Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) in a skilled nursing facility and comparison to the 4 ‘A’s test (4AT)

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